Overview

In 2005, the Deficit Reduction Act (DRA) Section 5201(c) (2) was passed by Congress and added section 1895(b) (3) (ii) (V) to the Social Security Act requiring each home health agency to submit to, the Secretary such data that the Secretary determines are appropriate for the measurement of health care quality…for 2007 and each subsequent year. The law also requires the Secretary to establish procedures for making data submitted available to the public and ensure the home health agency has the opportunity to review the data prior to the data being made public. Section 5201 (c)(v) requires a payment adjustment if a home health agency does not submit data for the reporting year, "the home health market basket percentage increase applicable for such year shall be reduced by 2 percentage points. (See Downloads section below for the DRA.)

Home health agencies that submit the required quality data using OASIS will receive payments based on the full home health market basket update for CY 2007. If a home health agency does not submit quality data, the home health market basket will be reduced by 2 percentage points for CY 2007. (See Press Release in the Related Links Within CMS section below.)

In response to the DRA requirements, CMS published information about the quality measures in the Federal Register as a Proposed Rule on August 3, 2006 and as a Final Rule on November 9, 2006. (See these Rules in the download section below.) We proposed, and made final, the decision to use OASIS data and the ten publicly reported quality measures on Home Health Compare, as the appropriate measure on home health quality. Continuing to use the OASIS data set is intended to mitigate the burden and cost of reporting through a separate mechanism.

CMS modified the timeframe for the data reported on Home Health Compare to align with the new DRA reporting timeframe. The initial reporting year is from July 2005 through June 2006. The next scheduled refresh of data is expected to occur on December 21, 2006 and these data will reflect the time frame of July 2005 through June 2006. CMS also publishes an annual "Preview Report?20in fall of each year available to home health agencies on the Casper Reporting system. The Iowa Foundation for Medical Care, a CMS contractor, sent a memorandum to each state agency in November 2006 and posted the memorandum in the OASIS State Welcome Page in their folders to advise them of the preview reports and how to access them. (See QTSO Memorandum 2006-122, published November 17, 2006 in the Downloads section below.)

Proposed Reporting of Quality Data for CY 2008
CMS proposes payment changes for Medicare Home Health Services and changes in reporting quality data for CY 2008 in the proposed rule CMS-154-P published May 4, 2007. (See Related Links Within CMS below)

HHAs collect and report Outcome and Assessment Information Set (OASIS) data. For CY 2008, CMS proposes to evaluate home health care quality by continuing to rely on the submission of OASIS assessments. Continuing to use the current OASIS instrument ensures that providers would avoid any additional burden of reporting through a separate mechanism and any related costs associated with the development and testing of a new reporting mechanism.

The proposed rule includes a provision to continue to adjust payment for reporting of quality data. HHAs that submit the required quality data would receive payments based on the proposed full home health market basket update of 2.9 percent for CY 2008. If a HHA does not submit quality data, the home health market basket percentage increase would be reduced by 2 percentage points to 0.9 percent for CY 2008. CMS publicly reports the nationally accepted and approved quality measures through the Medicare Home Health Compare web site at www.medicare.gov. The proposed rule adds two National
Quality Forum-endorsed measures to the 10 that are currently reported:

• Emergent Care for Wound Infections, Deteriorating Wound Status; and

• Improvement in the Status of Surgical Wounds.

Additional information can be found in the Downloads or Related Links Within CMS section below.

Downloads
Fact Sheet - April 27, 2007  [PDF 155 KB] Section 5201 of the Deficit Reduction Act of 2005 [PDF 43 KB] CMS-1304-Proposed Rule - Home Health Prospective Payment System Rate Update for CY 2007 and Deficit Reduction Act of 2005, August 3, 2006, page 44082 [PDF 581 KB] CMS-304-Final Rule - Home Health Prospective Payment System Rate Update for CY 2007 and Deficit Reduction Act of 2005, November 9, 2006, page 65884 [PDF 701 KB] QTSO Memorandum 2006-122, published November 17, 2006 [PDF 38 KB]
Related Links Inside CMS
CMS-154-Proposed Rule - Home Health Prospective Payment System Home Health PPS Press Release - November 1, 2006
Related Links Outside CMS
There are no Related Links Outside CMS.

Page Last Modified: 07/17/2008 12:30:21 PM
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